Transitional Cell Cancer (Pelvis and Ureter)

General Information

What is transitional cell cancer of the renal pelvis and ureter?

Transitional cell cancer (TCC) of the renal pelvis and ureter is a disease in which cancer (malignant) cells are found in the tissues in the kidneys that collect urine (the renal pelvis) and/or in the tube that connects the kidney to the bladder (ureter).

The kidneys are a "matched" pair of organs found on either side of your backbone. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. Inside each kidney are tiny tubules that clean your blood, taking out waste products and making urine. The urine made by the kidneys passes through the ureter into the bladder where it is held until it is passed from your body. The renal pelvis is the part of the kidney that collects urine and drains it to the ureters. The cells that line the renal pelvis and ureters are called transitional cells, and it is these cells that are affected in TCC. If you have a more common type of kidney cancer called renal cell cancer, see the patient information statement on renal cell cancer.

Like most cancers, TCC of the renal pelvis and ureter is best treated when it is found (diagnosed) early. In the early stages of TCC you may not have any symptoms. The symptoms of TCC and other types of kidney cancer are similar to other types of kidney disease. You should see your doctor if you have blood in your urine or pain in your back.

If you have symptoms, your doctor will usually feel your abdomen for lumps. A narrow lighted tube called a ureteroscope may be inserted through the bladder into the ureter so that your doctor can look inside the ureter and renal pelvis for signs of cancer. If cancer cells are found, your doctor may take out a small piece of the tissue to look at under the microscope. This is called a biopsy. Your doctor may also do a special x-ray called a CT scan or a scan that uses magnetic waves (MRI) to look for lumps.

Your chance of recovery (prognosis) and choice of treatment depend on the stage of your cancer (whether it is just in the tissue lining the inside of the ureter or renal pelvis or has spread to other places) and your general state of health.

Stage Information

Stages of transitional cell cancer of the renal pelvis and ureter:

Once transitional cell cancer is found, more tests will be done to find out if cancer cells have spread to other parts of the body (staging). Your doctor needs to know the stage to plan treatment.

The following stages are used for TCC of the renal pelvis and ureter:

The cancer is only in the area where it started and has not spread outside the kidney or ureter.

The cancer has spread to the tissue around the kidney or to lymph nodes in the pelvis. (Lymph nodes are bean-shaped structures that are found throughout the body. They produce infection-fighting cells.)

The cancer has spread to other parts of the body.

Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the original area or in another part of the body.

Treatment Option Overview

How transitional cell cancer of the renal pelvis and ureter is treated:

There are treatments for all patients with transitional cell cancer of the renal pelvis and ureter. The primary treatment is surgery (taking out the cancer in an operation). Radiation therapy (using high-dose x-rays to kill cancer cells), biological therapy (using your body's immune system to fight cancer), and chemotherapy (using drugs to kill cancer cells) are being tested in clinical trials.

Surgery is the most common treatment of transitional cell cancer of the renal pelvis and ureter. Your doctor may remove the tumor using one of the following operations:

1.The kidney, ureter, and top part of the bladder may be removed in an operation called a nephroureterectomy.
2.Segmental resection removes only part of the ureter or kidney.
3.Electrosurgery uses an electric current to remove the cancer. The tumor and the area around it are burned away and then removed with a sharp tool.
4.Laser therapy uses a narrow beam of intense light to remove cancer cells.

Electrosurgery and laser therapy are used only for cancers that are on the surface of the renal pelvis or ureter.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. Chemotherapy may also be put directly into the ureter or pelvis (intraureteral or intrapelvic chemotherapy).

Biological therapy tries to get your own body to fight cancer. It uses materials made by your own body or made in a laboratory to boost, direct, or restore your body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy.

Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external beam radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes (internal radiation therapy) in the area where the cancer cells are found.

Treatment By Stage

Your choice of treatment depends on how far the cancer has spread and your general health.

You may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to go into a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are going on in most parts of the country for most stages of transitional cell cancer of the renal pelvis and ureter.

Localized Transitional Cell Cancer of the Renal Pelvis and Ureter:

Your treatment may be one of the following:

1. Surgery to remove the kidney, ureter, and the top part of the bladder
2. Surgery to remove part of the ureter or kidney (segmental resection).
3. A clinical trial of electrosurgery or laser therapy.
4. A clinical trial of intrapelvic or intraureteral chemotherapy or
biological therapy.

Regional Transitional Cell Cancer of the Renal Pelvis and Ureter:

Your treatment will probably be a clinical trial of radiation therapy and/or chemotherapy.

Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter:

Your treatment will probably be a clinical trial of chemotherapy.

Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter:

Your treatment will probably be a clinical trial of new treatments.

The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation.

The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. Any use of the information will be at the risk of the user.

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